Serum Interleukin-22 as a Marker of Decompensated Liver Cirrhosis and Hepatocellular Carcinoma in Chronic Hepatitis C Virus Patients

Abstract

Background and study aim: Chronic liver disease (CLD), when associated with chronic hepatitis C virus (HCV) infection, typically develops into cirrhosis and hepatocellular carcinoma (HCC). Early identification and accurate staging of the transition from compensated to decompensated cirrhosis are imperative for effective intervention and improved patient outcomes. HCC is the fourth leading cause of cancer death in Egypt. Consequently, the identification of novel biomarkers for early HCC diagnosis remains an essential clinical need. Interleukin-22 (IL-22), a cytokine implicated in hepatic fibrogenesis in the context of HCV infection, has emerged as a promising candidate biomarker warranting further investigation. Our study aimed to identify the serum levels and diagnostic performance of Interleukin-22 in HCV decompensated cirrhotic patients as well as HCC patients. Patients and Methods: The study was conducted on 80 individuals from Alexandria Main University Hospital, Tropical Medicine Department; they were divided into four groups. The first three groups consisted of 20 patients each. Group I included 20 patients with HCV-induced decompensated liver cirrhosis without HCC, group II included 20 patients with compensated liver cirrhosis without HCC while group III included 20 patients with HCC. Group IV consisted of 20 healthy controls. Serum IL-22 was measured by ELISA. Results: Serum IL-22 was significantly higher in HCC patients than in patients with decompensated and compensated cirrhosis. There was also a statistically significant difference between cirrhotic patients and controls (p=0.016). Serum IL-22 was significantly higher in decompensated cirrhosis patients than in patients with compensated cirrhosis. The Serum IL-22 cutoff point discriminating HCC cases from decompensated cirrhotic cases was >81 ng/ml, with a sensitivity of 95%, specificity of 95%, positive predictive value of 95%, and negative predictive value of 95%. Conclusion: Serum IL-22 is a sensitive biomarker that could predict the development as well as the aggressiveness of HCC in cirrhotic patients.